Infection Control

WHAT IS INFECTION CONTROL? Infection Control is the practice of preventing infection Infection Control is the practice of preventing infection Take steps to ensure that patients don’t acquire an infection while they are here in the hospital Take steps to ensure that patients don’t acquire an infection while they are here in the hospital TERM: Nosocomial (Hospital-Acquired) Infection TERM: Nosocomial (Hospital-Acquired) Infection FOR MORE INFORMATION, LOOK IN THE INFECTION CONTROL MANUAL LOCATED IN YOUR DEPARTMENT

Breaking the Chain of Infection THE MOST EFFECTIVE INFECTION CONTROL MEASURE TO PREVENT THE TRANSMISSION OF INFECTION IS: ** HAND HYGIENE ~ You can isolate a patient and wear your PPE, but if you DON’T CLEAN YOUR HANDS you will carry the infection to all the patients you touch

What’s on your hands? Hopefully not that! Remember!  Hand hygiene prevents the spread of infection  Good hand hygiene is the most important activity you can do to keep your patients infection free

Hand Hygiene at MRCH Hand washing with soap and water: Hand washing with soap and water: – Antimicrobial soap – Non antimicrobial soap Hand hygiene with alcohol gel Hand hygiene with alcohol gel – Exceptions for use: Physical debris on hands Physical debris on hands Protein matter on hands Protein matter on hands Spores Spores

Give Healthcare a HAND by washing yours! Before you start work Before you start work Before patient care Before patient care After patient care After patient care While providing care when moving While providing care when moving from not clean to clean areas Before invasive procedures Before invasive procedures Before sterile procedures Before sterile procedures After you remove gloves After you remove gloves The opportunities are endless!!! The opportunities are endless!!!

Personal Protective Equipment (PPE) Wear a barrier to protect against blood and bodily fluids: Wear a barrier to protect against blood and bodily fluids: – Gloves – Gown – Mask – Eye Protection

STANDARD PRECAUTIONS Based on the principle that all body fluids and excretions may contain transmissible infectious agents Based on the principle that all body fluids and excretions may contain transmissible infectious agents Practiced for all patients, all the time Practiced for all patients, all the time When you find yourself in a situation that might result in exposure to bodily fluids, utilize a barrier When you find yourself in a situation that might result in exposure to bodily fluids, utilize a barrier

Make a Partnership with Safety Use the appropriate personal protective equipment every time you need it. Use the appropriate personal protective equipment every time you need it. Utilize safety engineered devices the way they are intended to be used. Utilize safety engineered devices the way they are intended to be used. IF YOU WAIT UNTIL YOU GET SPLASHED, SPRAYED OR EXPOSED TO PUT YOUR PPE ON, IT IS TOO LATE ! THEY ARE INTENDED TO KEEP YOU SAFE!

TRANSMISSION BASED PRECAUTIONS Used in addition to Standard Precautions Used in addition to Standard Precautions Used when patient has organism that we don’t want to spread to other patients or acquire ourselves Used when patient has organism that we don’t want to spread to other patients or acquire ourselves Prevent spread by wearing a barrier (Personal Protective Equipment: PPE) specific to that mode of transmission Prevent spread by wearing a barrier (Personal Protective Equipment: PPE) specific to that mode of transmission

Contact Precautions Signage On the patient room door, you should see these signs: On the patient room door, you should see these signs:

Contact Precautions The Details Used for organisms that are spread by “contact” – by body surface to body surface: physical transfer Used for organisms that are spread by “contact” – by body surface to body surface: physical transfer Contact transmission is the most important and most frequent mode of transmission of nosocomial infections Contact transmission is the most important and most frequent mode of transmission of nosocomial infections KEEP ‘EM CLEAN!

Contact Precautions What Should I Wear? Wear GLOVES for all patient care – this includes hand contact with the environment! Wear GLOVES for all patient care – this includes hand contact with the environment! Wear GLOVES and GOWN for patient contact that could result in your uniform coming into contact with patient or patient’s environment Wear GLOVES and GOWN for patient contact that could result in your uniform coming into contact with patient or patient’s environment

Contact Precautions Used for What Diseases? Methicillin Resistant Staphylococcus aureus (MRSA) Methicillin Resistant Staphylococcus aureus (MRSA) Vancomycin Resistant Enterococcus (VRE) Vancomycin Resistant Enterococcus (VRE) Lice Lice Scabies Scabies Clostridium difficile Clostridium difficile E. coli 0157:H7 E. coli 0157:H7

Droplet Precautions Signage On the patient room door, you should see these signs: On the patient room door, you should see these signs:

Droplet Precautions The Details Used for organisms that are spread by respiratory droplets Used for organisms that are spread by respiratory droplets Respiratory droplets are generated by cough, sneeze, talk, laugh, suction, bronchoscopy, etc Respiratory droplets are generated by cough, sneeze, talk, laugh, suction, bronchoscopy, etc Respiratory droplets spread 3 to 5 feet from the source Respiratory droplets spread 3 to 5 feet from the source Droplets do not remain suspended in the air Droplets do not remain suspended in the air

Droplet Precautions What Should I Wear? Wear a MASK and GLOVES for all patient contact – this includes hand contact with the environment! Wear a MASK and GLOVES for all patient contact – this includes hand contact with the environment! If you are providing care that will likely result in your uniform coming into contact with the patient or the patient’s environment, wear a GOWN If you are providing care that will likely result in your uniform coming into contact with the patient or the patient’s environment, wear a GOWN If you are suctioning, intubating, patient has tracheostomy, etc – wear EYE PROTECTION If you are suctioning, intubating, patient has tracheostomy, etc – wear EYE PROTECTION

Droplet Precautions Used for What Diseases? MRSA in sputum MRSA in sputum Influenza Influenza Meningitis Meningitis Measles (Rubella) Measles (Rubella)

Airborne Precautions Signage On the patient room door, you should see these signs: On the patient room door, you should see these signs:

Airborne Precautions Used for What Diseases? Mycobacterium tuberculosis Mycobacterium tuberculosis Varicella Varicella Chicken Pox Chicken Pox

Airborne Precautions The Details How Airborne Precautions differ from Droplet Precautions: How Airborne Precautions differ from Droplet Precautions: – Used for diseases spread by airborne droplet nuclei (small particles) or evaporated droplets containing the microorganism – The particles can remain suspended in the air for long periods of time – The particles can be inhaled by others

Airborne Precautions What Should I Wear? Wear a N-95 MASK and GLOVES for all patient contact Wear a N-95 MASK and GLOVES for all patient contact Wear the MASK, GLOVES and GOWN when providing care that may result in exposure to bodily fluids or your uniform may come into contact with the environment Wear the MASK, GLOVES and GOWN when providing care that may result in exposure to bodily fluids or your uniform may come into contact with the environment

Airborne Precautions Anything Else I Should Know? These particles are small and can remain suspended on air currents for great distances These particles are small and can remain suspended on air currents for great distances Patients in Airborne Isolation need to be placed in a room with specific ventilation: Patients in Airborne Isolation need to be placed in a room with specific ventilation: – Negative Pressure

HAI Prevention: Clean Equipment - All equipment should be wiped down with a germicidal wipe (Sani Cloths) Between patient use Between patient use When equipment leaves a patient room (wheelchair, walkers, gurneys) When equipment leaves a patient room (wheelchair, walkers, gurneys)

Disposal of Waste “Clear Bags” Diapers or incontinence pads soiled with urine or feces can be disposed of in the “regular” garbage Diapers or incontinence pads soiled with urine or feces can be disposed of in the “regular” garbage Dry, non-confidential waste may be disposed of in the clear bags Dry, non-confidential waste may be disposed of in the clear bags

Disposal of Waste “Biohazard” Waste material saturated with blood or bodily fluids must be discarded in the biohazard waste container Waste material saturated with blood or bodily fluids must be discarded in the biohazard waste container Liquid waste material must be solidified before disposal (Isosorb) Liquid waste material must be solidified before disposal (Isosorb) Be sure to securely tie all biohazard bags Be sure to securely tie all biohazard bags

Disposal of Waste Sharps Sharps containers are for all things sharp Sharps containers are for all things sharp Sharp things include needles, scalpels, lancets, syringes, ampules Sharp things include needles, scalpels, lancets, syringes, ampules Sharp things are considered sharp even if the needle has been removed (syringe) Sharp things are considered sharp even if the needle has been removed (syringe) Sharp containers are not for tape, cotton balls or random garbage Sharp containers are not for tape, cotton balls or random garbage

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Disposal of Waste Pharmaceutical Waste Pharmaceutical waste containers are for pharmaceutical waste Pharmaceutical waste containers are for pharmaceutical waste – Pharmaceutical waste includes all medications and additives that have any ingredient other than sugar, salt or water – Do not dispose of pharmaceutical waste down the sink